- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29.01 / $50.28 / $50.28
| Facility | | $29.01 | $50.28 | $50.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.28 / $60.34 / $107.00
| Professional | | $50.28 | $60.34 | $107.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $90.22 / $327.81 / $549.05
| Facility | | $90.22 | $327.81 | $549.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.72 / $85.49 / $112.38
| Professional | | $47.72 | $85.49 | $112.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $145.13 / $171.63 / $221.03
| Facility | | $145.13 | $171.63 | $221.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $77.81 / $114.60 / $147.56
| Professional | | $77.81 | $114.60 | $147.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $65.81 / $65.81 / $383.66
| Facility | | $65.81 | $65.81 | $383.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $48.04 / $65.81 / $136.50
| Professional | | $48.04 | $65.81 | $136.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.43 / $4,618.00 / $9,239.00
| Facility | | $83.43 | $4,618.00 | $9,239.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $93.17 / $93.17 / $97.83
| Professional | | $93.17 | $93.17 | $97.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $66.92 / $66.92 / $66.92
| Professional | | $66.92 | $66.92 | $66.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $239.32 / $549.05 / $549.05
| Facility | | $239.32 | $549.05 | $549.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43.79 / $57.41 / $112.38
| Professional | | $43.79 | $57.41 | $112.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $140.44 / $140.44 / $140.44
| Facility | | $140.44 | $140.44 | $140.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $44.54 / $59.55 / $112.38
| Professional | | $44.54 | $59.55 | $112.38 |